Maternal intake of fat, riboflavin and nicotinamide and the risk of having offspring with congenital heart defects
Maternal intake of fat, riboflavin and nicotinamide and the risk of having offspring with congenital heart defects
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DOI：
10.1007/s00394-008-0735-6
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发表时间：
2008-10-01
影响因子：
5
通讯作者：
Steegers-Theunissen, Regine P. M.
中科院分区：
文献类型：
--
作者：
Smedts, Huberdina P. M.;Rakhshandehroo, Maryam;Steegers-Theunissen, Regine P. M.
除了叶酸的研究外，关于先天性心脏缺陷 (CHD) 发病机制中其他营养素的证据很少。脂肪酸在胚胎发育中起着核心作用，B 族维生素核黄素和烟酰胺是脂质代谢的辅酶。研究目的 调查母亲饮食中脂肪、核黄素和烟酰胺的摄入量与后代冠心病风险之间的关系。方法 对 276 名患有先天性心脏病（包括 190 例流出道缺陷（OTD）和 86 例非流出道缺陷（non-OTD））儿童的母亲和 324 名非畸形儿童的对照母亲进行了病例对照家庭研究。母亲在怀孕后 16 个月填写一般调查问卷和食物频率调查问卷，作为孕前时期习惯性食物摄入量的代表。通过曼-惠特尼 U 检验比较病例和对照之间的营养摄入量（中位数）。在逻辑回归模型中估计了 CHD 与营养摄入之间关联的优势比 (OR)。结果 病例母亲，尤其是患有 OTD 孩子的母亲，饮食中饱和脂肪摄入量较高，分别为 30.9 克/天和 29.8 克/天； P<0.05。 OTD 儿童母亲的核黄素和烟酰胺膳食摄入量低于对照组（分别为 1.32 与 1.41 毫克/天；P < 0.05 和 14.6 与 15.1 毫克/天；P < 0.05）。各组之间的能量、不饱和脂肪、胆固醇和叶酸摄入量相当。核黄素 (< 1.20 mg/d) 和烟酰胺 (< 13.5 mg/d) 的膳食摄入量过低会使儿童患 OTD 的风险增加两倍以上，特别是在围孕期未使用维生素补充剂的母亲中（OR 2.4，95%CI 1.4-4.0）。增加烟酰胺摄入量（OR 0.8，95%CI 0.7-1.001，每单位标准差增加）可降低冠心病风险，与膳食叶酸摄入量无关。结论 孕产妇饮食中饱和脂肪含量高、核黄素和烟酰胺含量低似乎会增加冠心病（CHD）风险，尤其是 OTD。
With the exception of studies on folic acid, little evidence is available concerning other nutrients in the pathogenesis of congenital heart defects (CHDs). Fatty acids play a central role in embryonic development, and the B-vitamins riboflavin and nicotinamide are co-enzymes in lipid metabolism. Aim of the study To investigate associations between the maternal dietary intake of fats, riboflavin and nicotinamide, and CHD risk in the offspring. Methods A case-control family study was conducted in 276 mothers of a child with a CHD comprising of 190 outflow tract defects (OTD) and 86 non-outflow tract defects (non-OTD) and 324 control mothers of a non-malformed child. Mothers filled out general and food frequency questionnaires at 16 months after the index-pregnancy, as a proxy of the habitual food intake in the preconception period. Nutrient intakes (medians) were compared between cases and controls by Mann-Whitney U test. Odds ratios (OR) for the association between CHDs and nutrient intakes were estimated in a logistic regression model. Results Case mothers, in particular mothers of a child with OTD, had higher dietary intakes of saturated fat, 30.9 vs. 29.8 g/d; P < 0.05. Dietary intakes of riboflavin and nicotinamide were lower in mothers of a child with an OTD than in controls (1.32 vs. 1.41 mg/d; P < 0.05 and 14.6 vs. 15.1 mg/d; P < 0.05, respectively). Energy, unsaturated fat, cholesterol and folate intakes were comparable between the groups. Low dietary intakes of both riboflavin (< 1.20 mg/d) and nicotinamide (< 13.5 mg/d) increased more than two-fold the risk of a child with an OTD, especially in mothers who did not use vitamin supplements in the periconceptional period (OR 2.4, 95%CI 1.4-4.0). Increasing intakes of nicotinamide (OR 0.8, 95%CI 0.7-1.001, per unit standard deviation increase) decreased CHD risk independent of dietary folate intake. Conclusions A maternal diet high in saturated fats and low in riboflavin and nicotinamide seems to contribute to CHD risk, in particular OTDs.